Vaginal cancer: The experience from 2 large academic centers during a 15-year period

Camille C. Gunderson, Elizabeth K. Nugent, Amanda C. Yunker, Rodney P. Rocconi, Whitney S. Graybill, Britt K. Erickson, Kathleen N. Moore

Research output: Contribution to journalArticle

11 Scopus citations

Abstract

OBJECTIVE: Limited data regarding the natural history, management, and prognosis of vaginal cancer exist owing to the relative disease rarity. MATERIALS AND METHODS: A retrospective chart review was performed at 2 institutions to identify women receiving treatment for vaginal cancer between 1990 and 2004. Demographics, risk factors, histology, International Federation of Gynecology and Obstetrics stage, treatment, and treatment-related complications were recorded. Statistical Analysis Software (SAS) version 9.2 was used. RESULTS: A total of 110 patients were identified in the 2 university databases. Median age was 63 years (range = 36-93 years), and 84% were white; 73% had squamous cell carcinoma, 40% were ever users of tobacco, and 64% had no abnormal Pap smear results. Of the patients, 83% had early-stage (I or II) disease. Treatment varied by stage with increasing use of radiation with advancing stage. Recurrence was 24%, 32%, and 53% for stage I, II, and III/IV disease, respectively. After a median follow-up of 21 months, progression-free survival was 59, 35, and 23 months for stage I, II, and III/IV disease, respectively. Overall survival was 106, 58, and 34 months for stage I, II, and III/IV disease, respectively. Age greater than 60 years (p = .0339; hazard ratio [HR] = 2.162), advanced stage (p = .0004; HR = 2.475), and tobacco use (p = .0004; HR = 1.02) were negatively associated with survival. Thirty percent developed a significant complication (fistula, stricture, cystitis, or proctitis), and 21% developed a vesicovaginal and/or rectovaginal fistula. There was no association of fistula development with age, stage, tobacco use, histological finding, or treatment history (including radiation therapy). CONCLUSIONS: Age, stage, and tobacco abuse seem to be negatively associated with survival in vaginal cancer. However, no risk factors were associated with fistula development.

Original languageEnglish (US)
Pages (from-to)409-413
Number of pages5
JournalJournal of lower genital tract disease
Volume17
Issue number4
DOIs
StatePublished - Oct 1 2013

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Keywords

  • fistula
  • radiation
  • vaginal cancer

Cite this

Gunderson, C. C., Nugent, E. K., Yunker, A. C., Rocconi, R. P., Graybill, W. S., Erickson, B. K., & Moore, K. N. (2013). Vaginal cancer: The experience from 2 large academic centers during a 15-year period. Journal of lower genital tract disease, 17(4), 409-413. https://doi.org/10.1097/LGT.0b013e3182800ee2